Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

Objective:To investigate the predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radical radiotherapy.Methods:A retrospective case series study was conducted. The clinical data of ESCC patients aged ≥ 70 years who received radical radiotherapy in Shanxi Province Cancer Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the radiotherapy planning system, the maximum transverse diameter of gross tumor volume of primary tumors (GTVt) and GTVt volume in the esophagus were calculated. The nutritional risk related indicators of ESCC patients before and after radiotherapy were calculated and recorded, including body mass index (BMI), geriatric nutritional risk index (GNRI), and neutrophil-to-lymphocyte ratio (NLR); Kaplan-Meier method was used for survival analysis, and log- rank test was performed; Cox proportional risk model was used to analyze the factors influencing the prognosis of patients. The overall survival (OS), progression-free survival (PFS), short-term efficacy, and adverse reactions of patients with different clinicopathological characteristics were compared.Results:The last follow-up time was 30 December, 2023. The 1-year, 3-year, and 5-year OS rates of 161 elderly patients with ESCC were 79.5%, 33.9%, and 16.1% respectively, with a median OS time of 25.8 months (95% CI: 20.11-31.49 months); the 1-year, 3-year, and 5-year PFS rates were 65.8%, 28.9%, and 14.8%, respectively, with a median PFS time of 20.0 months (95% CI: 16.31-23.69 months). There were statistically significant differences in the median OS time of patients with different age, lesion contrast length, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, NLR before radiotherapy, and NLR after radiotherapy (all P < 0.05); there were statistically significant differences in the median PFS time of ESCC patients with different age, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy (all P <0.05). The results of multivariate Cox regression analysis showed that the maximum transverse diameter of GTVt was an independent influencing factor of the patients' OS ( P < 0.05); GTVt volume, short-term efficacy, GNRI after radiotherapy, and NLR before radiotherapy were independent influencing factors for OS and PFS of the patients (all P < 0.05). Among 161 elderly patients with ESCC, 45 achieved complete remission (CR), 111 achieved partial remission (PR), and 5 achieved stable disease (SD). There were statistically significant differences in the proportions of patients with different maximum transverse diameter of GTVt, GTVt volume, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy reaching CR and PR+SD (all P < 0.05). Among the 161 patients, grade 0, 1, 2, and 3 radiation-induced esophagitis (RE) occurred in 59, 54, 42, and 6 cases, respectively during treatment and within 3 months after treatment; among them, ≥ grade 2 RE occurred in 48 cases (29.8%); grade 0, 1, 2, and 3 radiation pneumonitis (RP) occurred in 95, 38, 25, and 3 cases, respectively; among them, ≥ grade 2 RP occurred in 28 cases (17.4%). Conclusions:Nutritional risk related indexes GNRI and NLR may be predictive indicators for the prognosis of elderly ESCC patients undergoing radical radiotherapy.

Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

OBJECTIVE To evaluate the influence of pharmaceutical quality control on the efficiency and outcomes of standardized medication therapy management （MTM） services for patients with coronary heart disease by using Economic， Clinical and Humanistic Outcomes （ECHO） model. METHODS This study collected case data of coronary heart disease patients who received MTM services during January-March 2023 （pre-quality control implementation group， n＝96） and June-August 2023 （post-quality control implementation group， n＝164）. Using propensity score matching analysis， 80 patients were selected from each group. The study subsequently compared the economic， clinical， and humanistic outcome indicators of pharmaceutical services between the two matched groups. RESULTS There were no statistically significant differences in baseline data between the two groups after matching （P＞0.05）. Compared with pre-quality control implementation group， the daily treatment cost （16.26 yuan vs. 24.40 yuan， P＜0.001）， cost-effectiveness ratio [23.12 yuan/quality-adjusted life year （QALY） vs. 32.32 yuan/QALY， P＜0.001]， and the incidence of general adverse drug reactions （2.50% vs. 10.00%， P＝0.049） of post-quality control implementation group were decreased significantly； the utility value of the EuroQol Five-Dimensional Questionnaire （0.74± 0.06 vs. 0.71±0.07， P＝0.003）， the reduction in the number of medication related problems （1.0 vs. 0.5， P＜0.001）， the medication adherence score （[ 6.32±0.48） points vs. （6.10±0.37） points， P＝0.001]， and the satisfaction score （[ 92.56±1.52） points vs. （91.95±1.56） points， P＝0.013] all showed significant improvements. Neither group experienced serious adverse drug reactions. There was no statistically significant difference in the incidence of new adverse reactions between the two groups （1.25% vs. 3.75%， P＝0.310）. CONCLUSIONS Pharmaceutical quality control can improve the quality of pharmaceutical care， and the ECHO model can quantitatively evaluate the effect of MTM services， making pharmaceutical care better priced and more adaptable to social needs， thus being worthy of promotion.

Objective:To investigate the predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radical radiotherapy.Methods:A retrospective case series study was conducted. The clinical data of ESCC patients aged ≥ 70 years who received radical radiotherapy in Shanxi Province Cancer Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the radiotherapy planning system, the maximum transverse diameter of gross tumor volume of primary tumors (GTVt) and GTVt volume in the esophagus were calculated. The nutritional risk related indicators of ESCC patients before and after radiotherapy were calculated and recorded, including body mass index (BMI), geriatric nutritional risk index (GNRI), and neutrophil-to-lymphocyte ratio (NLR); Kaplan-Meier method was used for survival analysis, and log- rank test was performed; Cox proportional risk model was used to analyze the factors influencing the prognosis of patients. The overall survival (OS), progression-free survival (PFS), short-term efficacy, and adverse reactions of patients with different clinicopathological characteristics were compared.Results:The last follow-up time was 30 December, 2023. The 1-year, 3-year, and 5-year OS rates of 161 elderly patients with ESCC were 79.5%, 33.9%, and 16.1% respectively, with a median OS time of 25.8 months (95% CI: 20.11-31.49 months); the 1-year, 3-year, and 5-year PFS rates were 65.8%, 28.9%, and 14.8%, respectively, with a median PFS time of 20.0 months (95% CI: 16.31-23.69 months). There were statistically significant differences in the median OS time of patients with different age, lesion contrast length, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, NLR before radiotherapy, and NLR after radiotherapy (all P < 0.05); there were statistically significant differences in the median PFS time of ESCC patients with different age, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy (all P <0.05). The results of multivariate Cox regression analysis showed that the maximum transverse diameter of GTVt was an independent influencing factor of the patients' OS ( P < 0.05); GTVt volume, short-term efficacy, GNRI after radiotherapy, and NLR before radiotherapy were independent influencing factors for OS and PFS of the patients (all P < 0.05). Among 161 elderly patients with ESCC, 45 achieved complete remission (CR), 111 achieved partial remission (PR), and 5 achieved stable disease (SD). There were statistically significant differences in the proportions of patients with different maximum transverse diameter of GTVt, GTVt volume, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy reaching CR and PR+SD (all P < 0.05). Among the 161 patients, grade 0, 1, 2, and 3 radiation-induced esophagitis (RE) occurred in 59, 54, 42, and 6 cases, respectively during treatment and within 3 months after treatment; among them, ≥ grade 2 RE occurred in 48 cases (29.8%); grade 0, 1, 2, and 3 radiation pneumonitis (RP) occurred in 95, 38, 25, and 3 cases, respectively; among them, ≥ grade 2 RP occurred in 28 cases (17.4%). Conclusions:Nutritional risk related indexes GNRI and NLR may be predictive indicators for the prognosis of elderly ESCC patients undergoing radical radiotherapy.

Objective To investigate the mechanism by which lectin-like oxidized low density lipoprotein receptor-1(LOX-1)regulates hyperglycemic-induced myocardial fibroblast(CFs)fibrosis through the glycogen synthase kinase-3β(GSK-3β)/signal transducer and activator of transcription 3(STAT3)pathway.Methods CFs were isolated,cultured and identified.LOX-1 RNAi lentiviral vector was constructed and infected CFs.The experimental groups were as follows:Normal control(NC)group,High glucose(HG)group,LV-LOX-1,LV-Con group,Hypertonic(HPG)group.After LV-LOX-1 and LV-Con were infected with CFs,adding 25 mmol/L glucose to culture CFs for 24 h,they were denoted as HG+LV-LOX-1 group and HG+LV-Con group.Cells in HG+LV-LOX-1 group and HG+LV-Con group were treated with 10 μ mol/L SB216763 and 10 μ mol/L STATTIC for 24 h,respectively,and then they were recorded as HG+LV-LOX-1+SB216763 group,HG+LV-Con+SB216763 group,HG+LV-LOX-1+STATTIC group and HG+LV-Con+STATTIC group.CCK-8 was used to detect the activity of CFs,and the expression levels of mRAN and protein of LOX-1,collagen type I(COL-I),thioredoxin 5(TXNDC5),GSK-3β,STAT3,p-GSK-3β and p-STAT3 were detected by qRT-PCR and Western blot.Results CFs infected with LOX-1 RNAi lentiviral vector were obtained,which showed green under fluorescence microscopy.Compared with HG and HG+LV-Con groups,the mRNA expressions of LOX-1,COL-I and TXNDC5 were decreased in HG+LV-LOX-1 group(P<0.05).Compared with HG+LV-LOX-1 group,mRNA expressions of COL-I and TXNDC5 were decreased in HG+LV-LOX-1+SB216763 and HG+LV-LOX-1+STATTIC groups(P<0.05).Compared with HG and HG+LV-Con groups,p-GSK-3β protein expression was increased in HG+LV-LOX-1 group(P<0.05),while LOX-1,p-STAT3,COL-I,TXNDC5 protein expression was decreased in HG+LV-LOX-1 group(P<0.05).Compared with HG+LV-LOX-1 group,p-GSK-3β protein expression was increased in HG+LV-LOX-1+SB216763 group(P<0.05),while the protein expressions of p-STAT3,COL-I and TXNDC5 were decreased in HG+LV-LOX-1+SB216763 and HG+LV-LOX-1+STATTIC groups(P<0.05).Conclusion LOX-1,GSK-3β,STAT3,TXNDC5,and COL-I are involved in high glucose induced CFs fibrosis.LOX-1 promotes the expression of TXNDC5 and COL-I through GSK-3β/STAT3 pathway,and inhibition of LOX-1 can inhibit high glucose induced CFs fibrosis.

Objective To investigate the molecular mechanism of lectin-like oxidized low-density lipoprotein receptor 1(LOX-1)in the regulation of high glucose induced phagocytosis dysfunction of mouse microglia(BV2 microglia).Methods BV2 cells were cultured in vitro,lentivirus LOX-1RNAi vector(LV-LOX-1)and lentivirusempty vector(LV-Con)were constructed and divided into normal control(NC)group,HG group,LV-LOX-1 group and LV-Con group.After infecting BV2 cells with LV-LOX-1 and LV-Con,the cells were cultured with 25 mmol/L glucose for 24 h,and then divided into HG+LV-LOX-1 group and HG+LV-Con group.After treatment of HG+LV-LOX-1 and HG+LV-Con infected BV2 microglia with 15 μmol/L FH535(β-catenin inhibitor)and AEBSF(ATF6α inhibitor)for 24 h,respectively,they were denoted as HG+LV-LOX-1+FH535 group,HG+LV-Con+FH535 group,HG+LV-LOX-1+AEBSF group,and HG+LV-Con+AEBSF group.Transfection efficiency was determined by fluorescence microscopy,RT-PCR and Western blot.Cell viability was detected b CCK-8.RT-PCR and Western blot were used to detect the mRNA and protein expression of LOX-1,β-catenin,ATF6α and milk fat globular-surface growth factor Ⅷ(MFG-E8)in each group.Results After 72 h of LV-LOX-1 infection,the cells in LV-LOX-1 and LV-Con groups showed a lot of green fluorescence,but not in NC group.Compared with NC group,the mRNA and protein expression of LOX-1 and ATF6α were increased(P<0.05),while the mRNA and protein expression of MFG-E8 and β-catenin decreased in HG group(P<0.05).Compared with HG+LV-Con group,the mRNA and protein expression of LOX-1 and ATF6α were decreased(P<0.05),while the mRNA and protein expression of MFG-E8 and β-catenin increasedin HG+LV-LOX-1 group(P<0.05).Compared with HG+LV-LOX-1 group,the mRNA and protein expressions of MFG-E8 and β-catenin were decreased(P<0.05),and the mRNA and protein expressions of ATF6α and p-β-catenin and p-ATF6α were increased in HG+LV-LOX-1+FH535 group(P<0.05).Compared with HG+LV-LOX-1 group,the mRNA and protein expression were increased(P<0.05),ATF6α mRNA and protein expression and p-ATF6α protein expression were decreased MFG-E8 in HG+LV-LOX-1+AEBSF group(P<0.05).Conclusions LOX-1,MFG-E8,β-catenin and ATF6α are involved in the regulation of phagocytosis of BV2 cells.LOX-1 promotes the phagocytosis dysfunction of BV2 microglia induced by high glucose through β-catenin/ATF6α signaling pathway.

Objective To investigate the effect of peripheral blood bile acids on the cognitive function of schizophrenia patients.Methods Targeted metabolomics was adopted to analyze the total level of primary and secondary serum bile acid metabolites collected from 23 schizophrenia patients and 23 health control individuals.The MATRICS Consensus Cognitive Battery(MCCB)was adopted to evaluate the subjects'cognitive function in five dimensions.Results We found that the schizophrenia patients had impaired cognitive functions in multiple dimensions including speed of processing,working memory,reasoning and problem solving,and visual learning.Compared with the health control group,serum levels of cholic acid(CA)and chenodeoxycholic acid(CDCA)were significantly lower in patients with schizophrenia,while serum level of glycocholic acid(GCA)was significantly higher,and the ratio of deoxycholic acid(DCA)to CA was higher(3.04 vs.1.16).Speed of processing,working memory,reasoning and problem solving,and visual learning abilities were significantly negatively correlated with serum levels of multiple primary bile acids including taurocholic acid(TCA),GCA,glycochenodeoxycholic acid(GCDCA)and taurochenodeoxycholic acid(TCDCA),after adjustments of age,sex,and body mass index.Conclusion The bile acid profile of schizophrenia patients is obvious,and the decrease in neuroprotective bile acids(namely,CA and CDCA)and the up-regulation of cytotoxic bile acid(i.e.,GCA)may impair the cognitive function of schizophrenia patients.

Objective:To study the effects of group B streptococcus (GBS) colonization during late pregnancy on vaginal microbiota and neonatal outcomes.Methods:From September 2020 to September 2021, pregnant women receiving prenatal care and delivered in our hospital were prospectively enrolled. They were assigned into GBS(+) group and GBS(-) group based on the results of GBS culture and/or PCR tests of vaginal secretions. The mothers were also assigned into early-onset infection(EO) group and non-early-onset infection(non-EO) group based on the presence or absence of early-onset infection of their neonates. The vaginal microbiota and neonatal outcomes were compared between these groups.Results:A total of 125 cases were enrolled, including 65(52.0%) in GBS(+) group and 60(48.0%) in GBS(-) group. 24 cases (19.2%) were in EO group and 101 cases (80.8%) in non-EO group. The incidences of premature rupture of membranes (PROM), amniotic fluid contamination, chorioamnionitis and early-onset neonatal infection in GBS(+) group were significantly higher than GBS(-) group(all P<0.05).The abundances of Streptococcus and Ureaplasma in vaginal flora of GBS(+) group were higher than GBS(-) group ( P<0.01), whereas Rhodococcus, Phyllobacterium and Bifidobacterium were lower than GBS(-) group ( P<0.05).The EO group had significantly higher abundance of enterococcus than the non-EO group ( P<0.05). Mothers with GBS colonization and neonates with early-onset infection had the highest abundance of Escherichia/Shigella ( P=0.04). Mothers with GBS colonization and neonates without early-onset infection showed the highest abundance of Gardnerella ( P=0.04). Conclusions:GBS colonization during late pregnancy increases the incidences of PROM, amniotic fluid contamination, chorioamnionitis and early-onset neonatal infection. GBS colonization causes abnormal vaginal flora in pregnant women. The increases of Ureaplasma, Streptococcus, Escherichia/Shigella and Enterococcus in vaginal microbiota maybe associated with early-onset neonatal infection.

Objective To investigate the protective effect and mechanism of magnesium isoglycyrrhizinate(MgIG)on cisplatin(CDDP)-induced myocardial injury in rats.Methods Twenty-four Wistar rats were randomly divided into the normal control group,the cisplatin model group(CDDP group),the cisplatin+magnesium isoglycyrrhizinate low-dose group(MgIG-L group)and the cisplatin+magnesium isoglycyrrhizinate high-dose group(MgIG-H group),with 6 rats in each group.Changes of body mass of rats were monitored daily.At the end of drug administration,cardiac function indexes including left ventricular ejection fraction(LVEF),left ventricular short-axis narrowing rate(LVFS),left ventricular end-systolic internal diameter(LVESD)and left ventricular end-diastolic internal diameter(LVEDD)were detected by echocardiography.The morphology of myocardial tissue was observed by HE staining.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of creatine kinase isoenzyme MB(CK-MB)and troponin I(cTnI).Levels of superoxide dismutase(SOD),malondialdehyde(MDA),glutathione synthase(GSH),reactive oxygen species(ROS)and ferrous ion(Fe2+)in homogenates of myocardial tissue were measured biochemically.The protein expressions of nuclear factor E2-associated factor 2(Nrf2),long-chain fatty acyl coenzyme A synthase 4(ACSL4),glutathione peroxidase 4(GPX4)and ferritin heavy chain 1(FTH1)protein were detected by Western blot assay.Results The body mass of rats in the control group showed an increasing trend during feeding,and the body mass of rats in the CDDP group showed a decreasing trend.Compared with the CDDP group,the body mass of rats in the MgIG-L group and the MgIG-H group increased after 5 d,9 d and 13 d of treatment(P＜0.05).Compared with the control group,the CDDP group showed decreased LVEF and LVFS,increased LVESD and LVEDD,disturbed myocardial fiber alignment,myocardial fiber degeneration and fracture,increased serum CK-MB and cTnI levels,increased levels of MDA,Fe2+and ROS in myocardial tissue,decreased levels of SOD and GSH,and decreased levels of Nrf2,GPX4,and decreased FTH1 protein expression levels and increased ACSL4 protein expression levels in myocardial tissue(P＜0.05).Compared with the CDDP group,the above indicators and myocardial histopathological changes were significantly improved in the MgIG-L group and the MgIG-H group.Conclusion Magnesium isoglycyrrhizinate can ameliorate cisplatin-induced myocardial injury by regulating myocardial oxidative stress and inhibiting cardiomyocyte iron death in rats.